Solitary confinement is a form of segregation in which people are held in total or near-total isolation in small cells for 23 hours a day. It is used to control and discipline detainees in federal and state prisons, local jails, and immigration and national security detention facilities. Unlike incarcerated prisoners, immigration and national security detainees are held not as punishment for a crime but as a preventive measure, and will likely never be charged with a crime. For these people, solitary confinement then becomes entirely punitive, with dire consequences for their mental and physical health.

Clinicians can assist asylum seekers and others seeking protection in the United States by providing objective documentation of their physical and psychological injuries and trauma. This documentation becomes evidence that can corroborate the asylum seeker’s narrative of persecution. This manual is a tool for clinicians to use in assisting their evaluation and documentation of asylum seekers' histories.
PHR intends to provide medical professionals with the information necessary to conduct these potentially life-saving evaluations by including an overview of political asylum law and procedure in the United States, an explanation of the physician's role in verifying signs and symptoms consistent with torture, and a review of components of appropriate written and oral medical testimony.

Immigrants in detention facilities around the United States are often subjected to punitive and long-term solitary confinement and denied meaningful avenues of appeal, according to an investigation by PHR and Heartland Alliance’s National Immigrant Justice Center (NIJC).

Today the Supreme Court struck down three provisions of Arizona’s controversial immigration law, commonly known as SB 1070. While the Court unanimously upheld a provision requiring state law enforcement agents to determine the immigration status of any person they stop if they have “reasonable suspicion” that the person is in the US illegally, the Court left the door open for future challenges to that provision.